Canadian Health Minister Deciding Fate of Vancouver Safe Injection Site

Our northern neighbors, those crazy Canadians, have instituted a semi-experimental program (semi only because they are prevalent throughout Europe and Australia) which allows injection drug users to "shoot up" their own drugs in a facility staffed by addiction counselors, nurses and persons in recovery. This program, called InSite, has actually been in operation since 2003 when the City of Vancouver, the Vancouver Police Department and various community groups asked the Canadian feds for an exemption to the controlled substances act. With the exemption granted, InSite opened it's doors and has since provided services to over 7000 people. The program has been examined intensely and has been showing that their services have reduced drug use, the harms associated with it, and cleaned up the streets. Here's an excerpt of some of the research results listed on their web site

Insite has been subject to rigorous, independent third party research and evaluation by the BC Centre for Excellence in HIV/AIDS, recognized as one of the world’s leading research organizations. The Centre’s research has been published in peer-reviewed journals including the New England Journal of Medicine, the British Medical Journal, the Canadian Medical Association Journal, and The Lancet.

Results include:

• Insite is leading to increased uptake into detoxification programs and addiction treatment. (New England Journal of Medicine)
• Insite has not led to an increase in drug-related crime, rates of arrest for drug trafficking, assaults and robbery were similar after the facility’s opening, and rates of vehicle break-ins/theft declined significantly. (Substance Abuse Treatment, Prevention, and Policy)
• Insite has reduced the number of people injecting in public and the amount of injection-related litter in the downtown eastside. (Canadian Medical Association Journal)
• Insite is attracting the highest-risk users – those more likely to be vulnerable to HIV infection and overdose, and who were contributing to problems of public drug use and unsafe syringe disposal. (American Journal of Preventive Medicine)
• Insite has reduced overall rates of needle sharing in the community, and among those who used the supervised injection site for some, most or all of their injections, 70% were less likely to report syringe sharing. (The Lancet)
• Nearly one-third of Insite users received information relating to safer injecting practices. Those who received help injecting from fellow injection drug users on the streets were more than twice as likely to have received safer injecting education at Insite. (The International Journal of Drug Policy)
• Insite is not increasing rates of relapse among former drug users, nor is it a negative influence on those seeking to stop drug use. (British Medical Journal)

The security of the program has recently been threatened, since the newly elected more conservative government has taken over. In purely reactionary statements provided without research, Health Minister Tony Clement virtually vowed to ensure that the programs would not succeed. However, shortly after threatening closure, he had a change of heart and allowed them to continue operations until the conclusion of certain research activities, or December 2007, at which point he intends to reviews the science to determine whether safe injections sites help or hinder public health.

According to a Jan. 4 article in Canada.com, Clement paid a surprise visit to InSite this week, (his first visit to the facility in fact) in effort to actually learn about the clinic, its goals, achievements and day to day activities. A commendable move for a person ultimately in charge of Canada's health policies.

He defended the fact that he did not visit before making that ruling. 'It's important for me to accentuate that I am here now,'' he said

''I had a good chat with the staff there, understood some of their procedures, asked a lot of questions, got a lot of answers,''Clement said after his tour.

But he declined to say whether his views had changed.

''I think I am continuing to get a deeper understanding and this is all part of being the best health minister I can be for the country,''he said.

With safe injection sites, Vancouver health officials are meeting drug users where they are at, intervening in addiction before users hit rock bottom, and providing safe injection equipment so that recovery will be unimpeded by deadly diseases. I hope Minister Clement takes a good look at the research, and prioritizes good public health policy over continued anti-drug war rhetoric. Nobody wants to encourage addiction, and while this program may seem counter-intuitive, it works to usher addicts into treatment earlier than they would have gone on their own, and without the complication of HIV/AIDS and hepatitis.